Skeletal and body-composition effects of anorexia nervosa

Article Abstract:

The eating disorder anorexia nervosa is characterized by excessive dieting and fasting; patients believe they are overweight even when they are dangerously thin. The type of body tissue most severely depleted in patients with anorexia is fat; it is not known whether muscle tissue is lost as well. The bones may be compromised, because anorectics are nutritionally deprived and may have hormone disturbances, such as elevated cortisol and reduced estrogen. The body composition, and particularly the bone mass, of anorectic women were compared with those of normal women. The subjects included 11 women who had suffered from anorexia nervosa for at least one year and were entering treatment at an eating disorders clinic. Ten subjects were 18 to 27 years of age, and one subject was 46 years old. All of the women were considered moderately malnourished, and all but one had a history of amenorrhea (lack of menstrual periods). Twenty-two normal young women were studied as well; both groups were examined using dual-photon absorptiometry, an imaging technique that shows both bone and soft tissue and produces films similar to X-rays. The anorectics weighed an average of 33 pounds less than the controls, and their total body fat mass was four times less than that of controls. Soft tissue mass was three times lower in the anorectics. The total skeletal mineral content was 25 percent lower in the patients with anorexia than in the controls, and the bone mineral density of the spine was especially reduced in the anorectics. It was concluded that dual-photon absorptiometry is useful for measuring the distribution of different body tissues such as bone, fat, and muscle, and that the technique may be helpful in assessing the nutritional status of patients with eating disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Eating disorders, Anorexia nervosa, Body composition

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Bone density in premenopausal women: effects of age, dietary intake, physical activity, smoking, and birth-control pills

Article Abstract:

Many factors have been identified that may influence bone mineral density (BMD) and bone mineral content (BMC), including physical activity, calcium intake, genetic background and use of oral contraceptives. Reductions in BMC and BMD increase the risk of bone fracture and osteoporosis, a bone disease that can lead to fractures and disability. The effects of physical activity, smoking, age, and calcium intake on BMD were determined in a two-year study of 300 white women, aged 20 to 39. In this study group, there was no evidence of bone mineral loss due to aging. However, in previous studies that included a wider age range (18 to 52), age-related declines in spine and femur (thigh-bone) BMD have been reported. In the current study, there was no effect of calcium or nutrient intake, or oral contraceptive use, on BMD. The relationship between BMD and physical activity has been shown to be dependent on the level of activity. Previous studies indicated that weight-bearing exercise tends to increase BMD. However, in the present study, moderate exercise was not associated with any changes in BMD. Smoking was associated with reduced spine and femur BMD. Of all the variables examined, body weight was the best predictor of BMD. It is concluded that calcium intake and physical activity do not have a major role in determining BMD in healthy, young, premenopausal women. Genetics and environmental factors not considered in this study may be more influential. Further studies are required to determine the long-term effects of calcium supplements on BMD. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aging, Bone density, Women's health

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Effects of moderate caffeine intake on the calcium economy of premenopausal women

Article Abstract:

A previous study showed that increased caffeine intake was associated with decreases in calcium intake and calcium balance, increased secretion of calcium from the intestines, and greater loss of calcium in the urine. Long-term caffeine intake may lead to calcium loss, and consequently, a decrease in bone mass. Hence, caffeine consumption is considered by some to be a risk factor for the development of osteoporosis, a disease involving loss of bone mass. However, whether caffeine intake increases the rate of bone loss has not been consistently demonstrated, particularly in men. The effect of 400 milligrams of caffeine per day on calcium metabolism was assessed in 16 healthy women who had not reached menopause, the cessation of menstruation. The subjects were given divided doses of caffeine (100 milligram tablets) or a placebo, a substance with no therapeutic effect, with decaffeinated coffee. Treatment periods lasted 19 days, and were separated by 37-day intervals. Caffeine did not affect the absorption of calcium or the amount of calcium in the feces or urine. However, caffeine intake was associated with changes in bone remodelling and small decreases in bone accretion, bone resorption, and calcium pool turnover (the amount of calcium that is metabolized). More research on this topic is needed, but the authors conclude that their findings support the theory that moderate caffeine intake in young women is not a risk factor for osteoporosis, as long as the women consume adequate amounts of calcium. (Consumer Summary produced by Reliance Medical Information, Inc.)

Caffeine, Calcium metabolism

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